Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🌈 "1 per Day!" Bariatric Multivitamins

Why such a long process? (Rant)

Jane1979

Recommended Posts

Jane1979    270

Jane1979
Posted

Why does it take so long from first appointment to surgery day? Can't all these tests be done within a couple of weeks? Papers don't go to insurance until all requirements have been met. Obviously, if you have a very high BMI and all the health issues that come along with it you need this surgery. What's with the proof of other methods tried? Yeah, I had a gym membership. Could t go anymore because it was just to damn painful (back and knee issues) but how do I PROVE that I actually showed up? I've told my PCP when I have gone on diets, but who's to say if she ever actually marked it in my charts? For all I know she thought I was making conversation. I k ow for a fact my insurance does not cover Optifast or any type of diet aid or pills. Cause it's cosmetic.

HOW exactly can they prove I did or didn't drink slim fast or did the south beach crap?

I'm still a long way from my first appointment. And after hearing it could be up to a year before a surgery date is rather discouraging. Hell, anyone can lose weight if all you have is broth and Jello. (Did that too for a couple weeks) lost and came right back because I got HUNGRY! it's insane all the "requirements"

Feel free to add your own rant.

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

KristenLe    5,979

KristenLe
Posted

@@Jane1979 Most of it is because of insurance bureaucracy - they want to delay as much as possible hoping you're give up and they won't have to shell out money for surgery! (I know that sounds cynical but I truly believe that's their intent). With that said - some preparation is necessary and helpful to prepare you for surgery. I think the nutrition counseling and psych eval (if done properly) and any recommended therapy is a good thing - this is a huge change and you need to be sure you understand that (so you won't be one of the people 2 days post op regretting it because you can't have a steak for dinner). ;-) Your insurance may not require 6 months of supervised weight loss - so it may go quicker for you. Many people have a faster track. If you are flexible with scheduling appointments and lab work ,etc. - it will go faster. Hang in there!!!

Share this post

Link to post
Share on other sites

Jane1979    270

Jane1979
Posted

@@KristenLe guess they rather pay my emergency room visits for the sever pain. But then also not want to pay for the pain meds that I need. I was supposed to be on Celebrex but those boogers are $300!!! Naturally the insurance didn't want to pay for that. I'm sure mines will be the longest track possible. Because my coverage is Nj health care. All they wanna do is give me a damn flu shot once a year but I can bet my life if I had a penis they would pay for me to take a pill to get it working

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

chrissychicago    9

chrissychicago
Posted

my insurance United Healthcare did not require any hoops!

Six weeks from first doctor appointment until surgery

Share this post

Link to post
Share on other sites

chrissychicago    9

chrissychicago
Posted

50!

unfortunately, but dropping every day!

I got very lucky - had the surgeon, nutritionist and psych visit in the same day. Two days for insurance approval and bam, - sleeved on July 19th.

Share this post

Link to post
Share on other sites

JustJoyce    1

JustJoyce
Posted

My first appt. is Sept 9th too, and with my insurance I have to do the 6 months dietary plan. But what if my BMI drops below 40, will I not be Approved????

Share this post

Link to post
Share on other sites

LisaMergs    2,854

LisaMergs
Posted

50!

unfortunately, but dropping every day!

I got very lucky - had the surgeon, nutritionist and psych visit in the same day. Two days for insurance approval and bam, - sleeved on July 19th.

congrats!

I'm in the Chicago area too, and I have BCBS PPO IL. My first appointment was just before Christmas and I originally had my surgery scheduled for March 4- but moved it to go on the road for a few days to see our Hawks play in St. Louis and Dallas. Doc wouldn't let me travel a week post op lol. Priorities!!! So I ended up March 23rd- 3 months after first appt and that was mostly due to scheduling with the NUT, psych and the endoscopy.

Where was your surgery? I was at Evanston.

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

Jen-2+1    131

Jen-2+1
Posted

I was seen at the surgeon in July, surgery will be in September. Just waiting on insurance approval at this point. Hopefully it will come through this week and I can get scheduled.

The first surgeon I saw runs a six month program no matter what your insurance requires. The second goes by insurance guidelines.

Share this post

Link to post
Share on other sites

laceemouse    631

laceemouse
Posted

My first appt. is Sept 9th too, and with my insurance I have to do the 6 months dietary plan. But what if my BMI drops below 40, will I not be Approved????

It totally depends on your insurance. Some WANT you to lose weight on a supervised program before surgery because they want to know that you are serious and will stick to your new eating program after surgery. Some want you to lose weight before surgery just to make it go more smoothly.

I do understand your concern. I am barely BMI 40, in fact when I first start looking into WLS they told me there was no way my insurance would pay because I was below 40 and had no other real health issues. Thankfully it looks like now that my BMI is 40 I have a good chance of approval and will not have to do any dietary plan before surgery.

So, my short answer is, it depends. Good luck to you!!

Share this post

Link to post
Share on other sites

chrissychicago    9

chrissychicago
Posted

50!

unfortunately, but dropping every day!

I got very lucky - had the surgeon, nutritionist and psych visit in the same day. Two days for insurance approval and bam, - sleeved on July 19th.

congrats!

I'm in the Chicago area too, and I have BCBS PPO IL. My first appointment was just before Christmas and I originally had my surgery scheduled for March 4- but moved it to go on the road for a few days to see our Hawks play in St. Louis and Dallas. Doc wouldn't let me travel a week post op lol. Priorities!!! So I ended up March 23rd- 3 months after first appt and that was mostly due to scheduling with the NUT, psych and the endoscopy.

Where was your surgery? I was at Evanston.

Sent from my iPhone using the BariatricPal App

I had surgery at Northwestern - I live downtown. Couldnt say enough nice things about them. 6 weeks tomorrow and I feel great! I was drinking whole glasses of Water in the hospital - never had to sip sip sip. I feel lucky

Share this post

Link to post
Share on other sites

angela9298    15

angela9298
Posted

I kind of felt the same way in the beginning but I'm actually glad for the process. I went to my first appointment in February and I'm scheduled for 9/26. The process gives you time to mentally prepare and get in your new mind set. The time goes by quickly.

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×